[Converging squint in severe hypermetropia (author's transl)].

The valuation of 541 cases of convergent squint occuring together with a hypermetropia of more than +5 dpt showed that, the stronger the hypermetropia was, the higher was the proportion of primary microstrabismus to full-accommodative strabismus convergens. In patients who had hypermetropia of more than +8 D, the proportion of primary microstrabismus was 46%. Here the squint was always one-sided, so a high proportion of amblyopia could be expected. In 10% of the cases there was a spontaneous change from convergent to divergent squint - the angle reduction was up to 23 degrees, and could occur at any age. Factors, which seem to favour the appearence of a consecutive divergence, are: high hypermetropia of more than +8 D, increased ACA-ratio, onesided exclusion and vertical divergence. The measuring of the ACA ratio should be done at all orthoptic examinations.